NPIMap

Organization Active NPI

Eldercare of Mid-Missouri Xiv Inc.

  • Skilled Nursing Facility
  • Owensville, MO
National Provider Identifier
1902294010
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ELDERCARE OF MID-MISSOURI XIV INC.
Practice address
1016 W Highway 28
Box 593
Owensville, MO 65066-1677
Phone
(636) 477-3280
NPI assigned
Dec 26, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Deanna Bokel
Title
Owner
Phone
(636) 477-3280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1016 W Highway 28
Box 593
Owensville, MO 65066-1677

Mailing address

2500 S Old Highway 94
Suite 104
Saint Charles, MO 63303-5616
Phone (636) 477-3280

Other names 1

  • StoneBridge Owensville Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150413001828 MO Part A Provider - Skilled Nursing Facility 3375861859 Practice locations: Owensville, MO

Skilled nursing facility certification: CCN 265670

Legal name
ELDERCARE OF MID-MISSOURI XIV INC
Doing business as
STONEBRIDGE OWENSVILLE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 11, 1997
Last certification
Aug 29, 2024
Beds
131
Ownership / control type
Corporation
Multi-facility organization
STONEBRIDGE SENIOR LIVING
Most recent change of ownership
Feb 1, 2015
Organization structure
CorporationProprietary
Enrollment address
1016 W Highway 28
Owensville, MO 65066-1677
Nursing home name
STONEBRIDGE OWENSVILLE
Affiliated entity
STONEBRIDGE SENIOR LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Stonebridge OwensvilleCCN 265670
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Mar 11, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
13172.0 residents per day on average
Chain
Stonebridge Senior Living12 facilities in the chain
Penalties (3 years)
2Fines totaling $20,383

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Eldercare of Mid-Missouri Xiv Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1016 W Highway 28
#593
Owensville, MO 65066
Phone (573) 437-6877

1016 W Highway 28
Owensville, MO 65066
Phone (573) 437-6877

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Beth Miller Individual Corporate OfficerSecretary Jan 17, 2023
Eric Doerhoff Individual Operational/Managerial Control Nov 1, 2021
Adp of the SNF Nov 1, 2021
Chelsea Daniels Individual Operational/Managerial Control Jan 6, 2025
Adp of the SNF Jan 6, 2025
Jeanne Thayer Individual Operational/Managerial Control Nov 1, 2021
Adp of the SNF Nov 1, 2021
Theresa Isaak Individual Operational/Managerial Control Apr 1, 2024
Adp of the SNF Apr 1, 2024
Wipfli LLP Organization, Clayton, MO Adp of the SNF Jan 1, 2025
Lierman Family Co Xiv, LLC Organization, Saint Charles, MO LLC Adp of the SNF Feb 1, 2015
Bridge Rehabilitation Inc Organization, Saint Charles, MO Corporation, Medical provider/supplier Operational/Managerial Control Feb 1, 2024
Adp of the SNF Apr 22, 2025
Mark W Lierman Individual 5% Or Greater Direct Ownership InterestPresident Nov 1, 2021 100%
Corporate OfficerPresident Nov 1, 2021 100%
Operational/Managerial Control Nov 1, 2021
Adp of the SNF Nov 1, 2021
First Mid Bank & Trust Organization, O'Fallon, MO Financial institution Operational/Managerial Control Jul 1, 2022
Forvis Mazars LLP Organization, Springfield, MO Consulting firm Adp of the SNF Jan 25, 2016
Eldercare Management Services Inc Organization, St Charles, MO Corporation, Management services company, Chain home office Operational/Managerial Control Feb 1, 2015
Adp of the SNF May 13, 2025
Greg Butz Individual Operational/Managerial Control Sep 15, 2020
Adp of the SNF Sep 15, 2020
Kim Freemont Individual Operational/Managerial Control Aug 16, 1995
Adp of the SNF Aug 16, 1995

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 11

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1419552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1902294010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 S OLD HIGHWAY 94",
            "address_2": "SUITE 104",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035616",
            "telephone_number": "636-477-3280",
            "fax_number": "636-477-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 W HIGHWAY 28",
            "address_2": "BOX 593",
            "city": "OWENSVILLE",
            "state": "MO",
            "postal_code": "650661677",
            "telephone_number": "636-477-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERCARE OF MID-MISSOURI XIV INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-26",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "BOKEL",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-477-3280"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "StoneBridge Owensville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Owensville, MO

Sources for this page

Verify at the official NPI Registry.